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Biomedical subjects

H W Randle

Publications and source records attributed to H W Randle.

At least 37 records · Page 2Linked to original sources
PubMed1993

Giant basal cell carcinoma (T3). Who is at risk?

BACKGROUND: Giant basal cell carcinomas can cause extensive local invasion and disfigurement. This study determines in whom giant basal cell carcinomas develop. METHODS: Fifty patients with giant basal cell carcinomas (over 5 cm, T3) were compared with other groups of patients with small (< 2 cm, T1) or intermediate-sized (2-5 cm, T2) basal cell carcinomas. The patients were treated at the Mayo Clinic between August 1986 and December 1990. RESULTS: Characteristics that were more common in giant basal cell carcinomas than in smaller lesions were duration, patient neglect, recurrence after previous treatment, aggressive histologic pattern, and history of radiation exposure. CONCLUSIONS: Patients who have a basal cell carcinoma with an aggressive histologic subtype, a recurrence after previous treatment, a history of radiation exposure, or a history of neglect are at risk for giant basal cell carcinoma.

Adult↗
PubMed1993

Histologic preparation for Mohs micrographic surgery. The single section method.

BACKGROUND: Tissue processed by Mohs micrographic surgery is usually cut into several sections before it is processed. OBJECT AND METHODS: We describe a single section method, in which the tissue is not subdivided, for preparing a tissue specimen for histologic examination in Mohs micrographic surgery. RESULTS: This technique saves time for both technicians, who prepare fewer specimens, and physicians, who have fewer histologic specimens to interpret. It may minimize false-positive margins and technical errors. CONCLUSIONS: Small specimens are handled best by this technique; however, the size of the specimen is limited only by the size of the cryostat chuck and histologic slide. The single section method is technically more difficult for preparing specimens that contain cartilage or ones that are extremely concave or convex, such as specimens from the conch of the ear.

Histocytological Preparation Techniques↗
PubMed1993

Treatment of oral ulcers.

Oral ulcers may be the result of allergic, infectious, metabolic, nutritional, or malignant systemic disorders or a variety of other inflammatory diseases. These range from minor irritations to signs of life-threatening illnesses. Patients with oral ulcers should adhere to a variety of general measures that are recommended plus specific treatments for specific diagnoses.

Aged↗
PubMed1992

Cutaneous micrographic surgery: Mohs procedure.

Skin cancer is an increasingly serious public health issue that affects a high percentage of the population. Surgical resection is still standard treatment for skin cancer, but for difficult cases, cutaneous micrographic surgery, originally described by Mohs, is our preferred technique because of the routine methodic accuracy for evaluation of the surgical margin, the high rate of oncologic cure, and the tissue-sparing quality of the procedure. We report the Mayo Clinic experience with cutaneous micrographic surgery from July 29, 1986, through June 30, 1991, which consisted of 3,355 cases (principally basal cell and squamous cell carcinoma). Herein we discuss practical concerns about this procedure: duration of the technique, reconstruction, cure rates, tumors best treated by cutaneous micrographic surgery, and cost. In addition, we review the Mayo Clinic multidisciplinary management of difficult skin cancers.

Adult↗
PubMed1991

Reversibility of blue-gray cutaneous discoloration from amiodarone.

A 45-year-old man had severe blue-gray cutaneous discoloration during amiodarone therapy for atrial fibrillation. Therefore, this drug regimen was discontinued, and long-term anticoagulation and digoxin therapy were used. The patient was advised to avoid exposure of his skin to sunlight, and a bleaching agent was prescribed. After 18 months of follow-up, the blue-gray hyperpigmentation had diminished. Although photosensitivity reactions from amiodarone occur in more than 50% of patients, blue-gray cutaneous discoloration occurs in less than 10% of patients on prolonged therapy with amiodarone. The presence of high concentrations of iodine, detected by electron probe analysis, suggests that the cutaneous deposits are amiodarone itself or a metabolite. The slow rate of elimination of amiodarone and a high uptake by fat-associated tissues may explain the delayed disappearance of cutaneous photosensitivity and late resolution of the blue-gray discoloration. Our current case supports the reversibility of these adverse effects on long-term follow-up.

Amiodarone↗
PubMed1987

White lesions of the mouth.

All white, hyperkeratotic lesions of the mouth should be studied by biopsy, unless an infection (thrush) or other obvious cause is recognized. The lesions should be classified as benign, dysplastic, or malignant, and the patient should be treated and followed appropriately.

Candidiasis, Oral↗
PubMed1986

Treatment of generalized lichen nitidus with PUVA.

Generalized lichen nitidus refractory to topical and systemic corticosteroids completely responded to PUVA. The similarity of lichen nitidus to lichen planus and the presumed lymphocytotoxic effect of PUVA were the bases for our use of oral photochemotherapy.

Adult↗
PubMed1986

Use of colchicine in Behçet's syndrome.

Colchicine is of benefit in the treatment of ocular, articular, oral, and genital lesions in BS. Polymorphonuclear neutrophil function, which is important in the pathogenesis of the disease, is modified by the drug. There is no evidence that colchicine alters the tendency for this disease to become chronic; however, the drug lessens the severity of certain manifestations and does not have the more deleterious side effects of prolonged steroid and immunosuppressive regimens.

Adult↗
PubMed1985

Recurrent cutaneous jellyfish eruptions without envenomation.

Three patients exhibiting recurrent cutaneous eruptions induced by contact with jellyfish tentacles are presented. The recurrent eruptions appeared several days after the primary exposure without contact with any offending coelenterate. The principal species involved include Pelagia noctiluca, Physalia physalis and probably Lychnorhiza lucerna. These three cases, combined with an earlier similar report of recurrent lesions induced by Physalia physalis suggest that this phenomenon may be widespread. In two of the three cases, the secondary eruption was more severe than that occurring after the primary envenomation.

Adolescent↗
PubMed1983

Further experience with toxic vitamin A therapy in pityriasis rubra pilaris.

A patient with short-duration pityriasis rubra pilaris was successfully treated with high-dose, toxic vitamin A (retinol), but the disease subsequently recurred in new areas. Serum levels of vitamin A were highest four hours after treatment and returned to the base level within twelve hours. Fasting blood levels of vitamin A during treatment increased to five times the pretreatment level. Ultrastructural changes in the keratinocytes were notable vacuolation, granularity of the cytoplasm, and a decrease in tonofilament masses, all indications of the cellular effect of the vitamin A. We believe that patients with long-duration pityriasis rubra pilaris should be considered for this treatment.

Aged↗
PubMed1981

Cutaneous immunofluorescence in primary biliary cirrhosis.

Biopsy specimens of normal skin of 11 patients with primary biliary cirrhosis were studied by immunofluorescence for immunoglobulin and complement deposition. Of the 11 patients, seven had positive immunofluorescent staining, primarily in a granular pattern either at the basement membrane zone or around the blood vessels or in both locations. The principal immunoglobulin noted was IgM, which, in six of the seven patients, was seen at the basement membrane zone or around the vessels (or both). Deposition with C3, fibrin, IgA, and IgG was seen less frequently. In this series of patients, cutaneous lesions included discoid lupus erythematosus, lichen planus, vitiligo, chronic bullous lesions of the legs, and scleroderma. Non-organ-specific immunologic markers in this group included elevated levels of IgG, IgM, and IgA, antinuclear antibodies, anti-nDNA, rheumatoid factor, antimitochondrial antibodies, smooth-muscle antibodies, and circulating immune complexes. We wish to add cutaneous immunofluorescence as an additional immunologic marker for primary biliary cirrhosis.

Adult↗
PubMed1980

The therapeutic response of urticarial vasculitis to indomethacin.

Ten patients with urticarial vasculitis, characterized clinically by persistent painful urticarial lesions, angioedema, recurrent arthralgia, abdominal pain, and low-grade fever, were selected for study. All patients had histologic evidence of leukocytoclastic vasculitis in the urticarial lesions. Results of direct immunofluorescence microscopy of urticarial lesions were positive in all nine of the patients tested. Treatment with indomethacin in dosages from 25 mg three times daily to 50 mg four times daily resulted in complete clearing of all disease manifestations in six of ten patients within 17 days and partial improvement in three. In eight of the ten patients, disease activity recurred within 48 hours after discontinuation of the use of indomethacin. Gastrointestinal irritation was the only side effect noted. Indomethacin is proposed as an effective mode of therapy in a disorder unresponsive to treatment with conventional medications for urticaria, including high-dose corticosteroids.

Adolescent↗
PubMed1980

Cutaneous granulomas in malignant lymphoma.

Two patients are described in whom the clinical manifestation of massive, localized dermal and subcutaneous epithelioid granulomatous masses occasioned an extensive year-long search for infectious organisms. In both instances, the true diagnosis of Hodgkin's disease or lymphoma was ultimately made by means of lymph node biopsy.

Adult↗